Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck

Waleed Fouad Mourad, Kenneth S. Hu, Dan Ishihara, Rania A. Shourbaji, Wilson Lin, Mahesh Kumar, Adam S. Jacobson, Theresa Tran, Spiros Manolidis, Mark Urken, Mark Persky, Louis Harrison

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives/Hypothesis To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN). Methods This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8%, 10%, 24%, and 58%, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35%) or concurrent chemo-RT (65%). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70%) were on HAART. Results RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100% developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤2 and 3 were 83% and 17%, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5%, 13%, and 15% of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26% and 23% of patients, respectively. Conclusion Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.

Original languageEnglish (US)
Pages (from-to)1178-1183
Number of pages6
JournalLaryngoscope
Volume123
Issue number5
DOIs
StatePublished - May 1 2013

Fingerprint

Radiotherapy
HIV
Drug Therapy
Xerostomia
Deglutition Disorders
Dysgeusia
Mucositis
Highly Active Antiretroviral Therapy
Carcinoma, squamous cell of head and neck
Weight Loss
Retrospective Studies
Therapeutics

Keywords

  • CD4
  • HAART
  • HIV
  • IMRT
  • Tolerance and toxicity
  • chemotherapy
  • radiotherapy
  • squamous cell carcinoma of the head and neck

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck. / Mourad, Waleed Fouad; Hu, Kenneth S.; Ishihara, Dan; Shourbaji, Rania A.; Lin, Wilson; Kumar, Mahesh; Jacobson, Adam S.; Tran, Theresa; Manolidis, Spiros; Urken, Mark; Persky, Mark; Harrison, Louis.

In: Laryngoscope, Vol. 123, No. 5, 01.05.2013, p. 1178-1183.

Research output: Contribution to journalArticle

Mourad, WF, Hu, KS, Ishihara, D, Shourbaji, RA, Lin, W, Kumar, M, Jacobson, AS, Tran, T, Manolidis, S, Urken, M, Persky, M & Harrison, L 2013, 'Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck', Laryngoscope, vol. 123, no. 5, pp. 1178-1183. https://doi.org/10.1002/lary.23874
Mourad, Waleed Fouad ; Hu, Kenneth S. ; Ishihara, Dan ; Shourbaji, Rania A. ; Lin, Wilson ; Kumar, Mahesh ; Jacobson, Adam S. ; Tran, Theresa ; Manolidis, Spiros ; Urken, Mark ; Persky, Mark ; Harrison, Louis. / Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck. In: Laryngoscope. 2013 ; Vol. 123, No. 5. pp. 1178-1183.
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abstract = "Objectives/Hypothesis To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN). Methods This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8{\%}, 10{\%}, 24{\%}, and 58{\%}, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35{\%}) or concurrent chemo-RT (65{\%}). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70{\%}) were on HAART. Results RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100{\%} developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤2 and 3 were 83{\%} and 17{\%}, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5{\%}, 13{\%}, and 15{\%} of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26{\%} and 23{\%} of patients, respectively. Conclusion Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.",
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T1 - Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck

AU - Mourad, Waleed Fouad

AU - Hu, Kenneth S.

AU - Ishihara, Dan

AU - Shourbaji, Rania A.

AU - Lin, Wilson

AU - Kumar, Mahesh

AU - Jacobson, Adam S.

AU - Tran, Theresa

AU - Manolidis, Spiros

AU - Urken, Mark

AU - Persky, Mark

AU - Harrison, Louis

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N2 - Objectives/Hypothesis To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN). Methods This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8%, 10%, 24%, and 58%, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35%) or concurrent chemo-RT (65%). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70%) were on HAART. Results RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100% developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤2 and 3 were 83% and 17%, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5%, 13%, and 15% of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26% and 23% of patients, respectively. Conclusion Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.

AB - Objectives/Hypothesis To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN). Methods This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8%, 10%, 24%, and 58%, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35%) or concurrent chemo-RT (65%). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70%) were on HAART. Results RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100% developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤2 and 3 were 83% and 17%, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5%, 13%, and 15% of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26% and 23% of patients, respectively. Conclusion Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.

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KW - IMRT

KW - Tolerance and toxicity

KW - chemotherapy

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